EPIDEMIOLOGY OF PANCREATIC CANCER IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN THE IVANO-FRANKIVSK REGION
Keywords:epidemiology, pancreatic cancer, diabetes mellitus, T3cDM
Increased cancer risk in patients with diabetes mellitus (DM) has an impact on the increase in rates of morbidity and mortality due to oncological diseases. An epidemiological study of pancreatic cancer (PSD) in patients with diabetes will facilitate differentiated approaches in the diagnosis of these diseases. The conducted epidemiological study included analysis of medical records of inpatients and outpatients with pancreatic cancer, which was detected in patients with type 2 diabetes in the Ivano-Frankivsk region during 2012−2016. The obtained results were processed by statistical methods in the programs «Microsoft Excel» and «Statistika-12». The first diagnosed pancreatic cancer was detected in 48 patients with type 2 diabetes. The pancreatic cancer incidence in patients with type 2 diabetes is higher compared to people without diabetes. Increased risk of pancreatic cancer in patients with type 2 diabetes was proved [OR = 1.46; 95 % CI (1.09–1.97); Р < 0.05]. Most often pancreatic cancer was diagnosed in patients aged 61−70 years (42 %) and older than 70 years old (33 %). The moderate severity of diabetes had 37 patients (77.1 %), mild — 8 patients (16.7 %), severe — 3 patients (6.3 %). Pancreatic cancer was diagnosed in 17 patients (35.4 %) with the duration of diabetes for up to 1 year, in 21 patients (43.8 %) − up to 5 years and 10 patients (20.8 %) — more than 5 years. BMI of patients was 25.47 ± 0.53 kg/m2 and was not statistically different between men and women (P > 0.05). Among patients with type 2 diabetes with the duration of disease up to 5 years, 17 (44.7 %) were treated with insulin and sulfonylurea derivatives without metformin, 13 patients (34.2 %) with metformin, 8 patients (21.1 %). have been on diet therapy. Patients with type 2 diabetes have been found to have an increased risk of pancreatic cancer, which is most commonly diagnosed in patients with diabetes with the moderate severity, lasting up to 5 years after age 60. Newly diagnosed type 2 diabetes in patients without obesity and without signs of insulin resistance must be differentiated from secondary T3cDM diabetes caused by possible damage to the thyroid gland by the malignant process. The need for early prescription of stimulants of insulin synthesis and insulin medications may be indirect evidence of T3cDM.
Zimmet PZ. Clin Diabetes Endocrinol 2017; 3: 1. doi: http://dx.doi.org/10.1186/s40842-016-0039-3.
Vlasenko MV. Mizhnar Endokrynol Zhurn 2011; 7 (39): 44-48.
Ferlay J, Soerjomataram I, Ervik M, et al. IJC 2014; 135(5): 359-386. doi: http://dx.doi.org/10.1002/ijc.29210.
World Health Statistics 2017: Monitoring health for the SDGs. Geneva: World Health Organization, 2017, available at: http://www.who.int/gho/database/en.
Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: World Health Organization, 2013, available at: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf.
Ukrainian cancer registry statistics, 2019. Cancer in Ukraine, 2017-2018: Bulletin of national cancer registry of Ukraine. 2019: 20 p.
Karen K Collins. Diab Spectrum 2014; 27(4): 276-280. doi: http://dx.doi.org/10.2337/diaspect.27.4.276.
Ukrainian cancer registry statistics, 2018. Cancer in Ukraine, 2017-2018: Bulletin of national cancer registry of Ukraine. 2018: 19 p.
Bonelli L, Aste H, Bovo P, et al. Pancreas 2003; 27(2): 143-149. doi: http://dx.doi.org/10.1097/00006676-200308000-00007.
Huxley R, Ansary-Moghaddam A, Berrington de Gonzбlez A, et al. Br J Cancer 2005; 92(11): 2076-2083. doi: http://dx.doi.org/10.1038/sj.bjc.6602619.
Johnston PC, Thompson J, Mckee A, et al. J Diabetes Res 2019: 2487804. doi: http://dx.doi.org/10.1155/2019/2487804.
De Souza A, Irfan K, Masud F, et al. JOP 2016; 17(2):144-148.
Campisi J. Annu Rev Physiol 2013;75: 685-705. doi: http://dx.doi.org/10.1146/annurev-physiol-030212-183653.
Balducci L, Ershler WB. Nat Rev Cancer 2005; 5: 655-662.
Park J, Morley TS, Kim M, et al. Nat Rev Endocrinol 2014;10: 455-465. doi: http://dx.doi.org/10.1038/nrendo.2014.94.
Pushkarev VM, Sokolova LK, Pushkarev VV, et al. Endokrynologia 2018; 23(2): 167-179.
Andersen DK, Korc M, Petersen GM, et al. Diabetes 2017; 66(5): 1103-1110. doi: http://dx.doi.org/10.2337/db16-1477.
Permert J, Ihse I, Jorfeldt L, et al. Eur J Surg 1993;159: 101-107.